Granting wishes: parents' perception of a wish fulfilment for a child with a life‐threatening illness

Research has consistently shown that negative life events disadvantage children in terms of health and quality of life (1). However, the emerging field of positive psychology (2) has led to research into the influence of positive emotionality on aspects of health (3). For instance, a recent study in adults specifically focusing on positive life events showed that these life events predicted cortisol levels (4). In addition, in the context of end-of-life care in adults, positive life events have been shown to have a favourable impact on well-being (5). In children, a positive life event, for instance, has been shown to counteract the risk of exacerbating asthma (6). The studies point to a growing interest in the influence of positive rather than negative life events. Nowadays positive life experiences are often offered to children with a life-threatening condition. Children are offered to participate in special events by charitable organizations, in order to create an unforgettable positive experience for the child and their family. One such organization is the Make-a-Wish Foundation, the Netherlands (M-a-W NL), which is part of The Make-A-Wish Foundation , which grants children’s wishes (such as swimming with dolphins or experiencing a day as a fireman). Many of such organizations organize events within the medical domain under the hypothesis that these events improve the lives of the recipients, that is, the participating patients and their families. Research on such activities (7,8) and the impact on patients and families have been particularly scarce, and it is therefore not clear to what extent they succeed in delivering this aim. Conversely, ethical points about the acceptability of these well-meant practices can be raised. While the event is likely to bring joy and energy, it is equally likely that the event may lead to exhaustion and therefore diminished well-being after the event. Being offered a wish might even be experienced as a ‘death sentence’ as the wish is only offered to children who have a life-threatening illness. Anecdotal evidence from reports from children whose wish was granted suggests that children and parents experience improvements in well-being and coping. There are also suggestions that for parents, once a child has died, the memories of the event may aid the bereavement process. However, negative outcomes are rarely discussed. This study, therefore, set out to retrospectively investigate the experience of children and parents during and after a wish is granted. Specifically, we were interested in finding out (i) what the general impression of parents was of such an event, (ii) whether it improved well-being and coping after the event and (iii) the influence of the event on bereavement for parents. The study was a cross-sectional retrospective investigation of parents of children who had a wish granted by the Make-a-Wish Foundation, the Netherlands. In the first instance, semistructured interviews were held with 17 sets of parents, which were independently analysed by two researchers to inform the development of a questionnaire. The written survey was developed drawing on the themes that emerged from this qualitative investigation of parents’ experiences of the wish fulfilment. Two groups of parents were invited to take part in the survey part of the study: (i) parents of children who were alive at the time of the study and (ii) parents of children who had died before the study assessment. Parents were randomly selected from the